Zykadia (ceritinib) — United Healthcare

Initial criteria

• Diagnosis of anaplastic large cell lymphoma
• AND Tumor is anaplastic lymphoma kinase (ALK)-positive
• AND Disease is relapsed or refractory
• AND Used as palliative intent therapy or second-line and subsequent therapy

Reauthorization criteria

• Patient does not show evidence of progressive disease while on Zykadia therapy

Approval duration

12 months